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Enterobacterias productoras de carbapenemasas: relación entre colonización e infección

Authors: Vidal Arboiro, José Manuel;

Enterobacterias productoras de carbapenemasas: relación entre colonización e infección

Abstract

RESUMEN: INTRODUCCIÓN: las escalas GRS e ICS se han validado en pacientes colonizados por enterobacterias productoras de carbapenemasas (EPC)-KPC para estimar la probabilidad de infección por EPC y la mortalidad, respectivamente. Sin embargo, no existen herramientas similares para EPC OXA-48, más frecuentes en nuestro medio. OBJETIVOS: Estudiar las características de los pacientes colonizados por EPC OXA-48, y analizar la utilidad de las escalas GRS e ICS en estos pacientes para predecir infección por EPC y mortalidad. MATERIAL Y MÉTODOS: Estudio de cohortes prospectivo de todos los pacientes colonizados por EPC OXA-48 en el HUMV entre 2016-2018. Los pacientes fueron clasificados según presentasen GRS 7, e ICS 8. RESULTADOS: Se incluyeron 55 pacientes colonizados por EPC OXA-48 (50,9% mujeres; media de edad: 74,4 años (DE: 13,5). 24 pacientes (43,6%) desarrollaron infección (50% EPC OXA-48). La mortalidad fue del 16,4%. No se encontraron diferencias significativas en la proporción de pacientes con infección por EPC OXA-48 al clasificarlos según su puntuación GRS, ni en la mortalidad al clasificarlos según su puntuación ICS. DISCUSIÓN Y CONCLUSIONES: Las escalas GRS e ICS no son útiles para calcular el riesgo de infección por EPC y mortalidad en pacientes colonizados por EPC OXA-48.

ABSTRACT: BACKGROUND: GRS and ICS scales have been validated to estimate the risk of carbapenemase-producing-enterobacteriae (CPE) infection and the risk of mortality, respectively, in patients colonized by KPC CPE. However, there are no similar tools to asess these risks for OXA-48 CPE, which are more frequent in our hospitals. OBJECTIVES: To study OXA-48 CPE colonized patients' characteristics and to analyze GRS and ICS scales' utility to predict CPE infections and mortality. MATERIAL AND METHODS: Prospective cohort study of all OXA-48 CPE colonized patients in HUMV between 2016-2018. Patients were classified by their GRS score (7) and their ICS score (8). RESULTS: 55 OXA-48 CPE colonized patients were included (50,9% women, median of age: 74,4 years (SD: 13,5). 24 patients developed infection (50% OXA-48 CPE). Mortality was 16,4%. No significative differences were found regarding OXA-48 CPE infections between the two GRS scale groups, nor between the two ICS scale groups regarding mortality. DISCUSSION AND CONCLUSIONS: GRS and ICS scales are not useful to predict the risk of developing CPE infection or the risk of mortality, respectively, in OXA-48 CPE colonized patients.

Grado en Medicina

Keywords

Carbapenemasas, Enterobacteriaceae, Enterobacterias, Nosocomial, Carbapenemases, Multi-resistant, Multirresistente, OXA-48

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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
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